Dosing/BG question/advice? Syko AMPS 130, +2 76, +2.5 92, +6 137, +9 131, PMBG 124

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meowsyko

meowsyko

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We had a stressful day today. Syko's BG was the lowest I've seen (4.2) at +2 and I had to leave to take my fiance to the hospital for a colonoscopy shortly after. So I let her eat some kibble and worried about her for the 2.5 hours we were at the hospital, feeling like a bad mommy. She was fine. This is the first 'green' I've seen with her.

I tried to take as many levels as I could today. I'm not sure why, but her BG has started going down again. not by much, but I'm afraid to give her her shot... I read that some cats can go a bit lower at the end of the cycle, but I haven't seen her do this before. I got new strips this week, and I'm done working now, so will try testing more often.

She had a tiny bit of dry kibble (hill's d/d) at +2 (I panicked cause I had to leave her) and 1/4 can of wet d/d (her usual) around +9 because she was scavenging around looking for food.

She's eating her dinner now. I think I should probably skip or reduce her evening dose? :confused: I'm still trying to figure out when to give her her shot and when to reduce or skip it... and not even completely sure what numbers I should be aiming for... (blue and green?)
any dosing advice would also be great, as I'm completely off what the Vet wanted (2u am 1u pm) and I've had trouble keeping her dose consistent. If somebody could give me a general guideline (what is too low to shoot, when should I worry...) that would be most helpful :cat:.

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Good luck with your Kitty!

I just did another test, Syko is up to 144 now. I'll probably go ahead and give her her shot.. It's only about 40min late if I give it to her now.
 
The next time you're not sure about whether you should shoot or not, stall, don't feed and post for help....Make sure your subject line is really clear and says something like "STALLING...NEED HELP!"

Now that you've fed her, her numbers will be influenced by food...what we usually do is stall and retest in 20-30 minutes to see if the numbers are coming up on their own which would indicate the insulin is wearing off and it's probably going to be fine to go ahead and shoot

That 144 is a food spike, so unless you can wait for 2 hours since she's had food, I'd skip tonight

You're not testing enough right now to do Tight Regulation, and since she's still eating dry, she has to be on Start Low, Go Slow....that means that that 76 today earns her a reduction in dose so she needs to go down to .75 unit

Below 90 (on either type of meter) is an automatic reduction of .25 unit on SLGS

For now, since you've fed her, I think it's best to just skip tonight and get back on track in the morning
 
Okay, thank you. I'll skip it tonight. I will probably be up in 2 hours but then it's almost 3 hours late, so skipping sounds like a better idea..
She is eating wet food, but it isn't very low-carb (I think around 20%). I just gave her some kibbles to munch on while I was away today since she was pretty low and I needed to leave for a couple hours to go to the hospital, and usually she will graze and eat a tiny bit of kibble every 30min or so.

I'll start .75u tomorrow. I haven't been able to test much since I was working full-time, but I'm done work as of yesterday so I plan to do it more often.
 
You might want to lay in a supply of Mid-carb and High Carb food for situations like that. Also, a timed feeder could be helpful. You can set it to turn at whatever increments you want to give her food while you're gone. While dry food will raise her BG, it stays in the system longer than wet, so it's not ideal for most situations.

Housekeeping note: When you refer to the test you took at what would have been her shot time in your condo, if you did not give insulin, you call it a PMBG (or AMBG). That helps us know right away that you did not shoot. To help you figure out some of the terms we throw around here, have a look at the Lantus & Levemir Land Slang Dictionary.

I know your vet wanted you to shoot two different doses at am and pm, but Lantus does much better with consistent dosing, so whenever possible, it's best to shoot the same amount both shot times. Sounds like you're already figuring that out! So starting in the morning, you'd shoot .75 units at am and pm, and hold that dose for at least six cycles, unless Syko lets you know it's too much by dropping under 68 (assuming you are switching to TR?).

Ask lots of questions. There are tons of people here to help you figure this out!

 
Tricia Cinco(GA) & Harvey said:
You might want to lay in a supply of Mid-carb and High Carb food for situations like that. Also, a timed feeder could be helpful.
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She's a very lazy old lady, I doubt she would actually learn to go to the timed feeder to eat. She spends most of the day in bed :D

Tricia Cinco(GA) & Harvey said:
Housekeeping note: When you refer to the test you took at what would have been her shot time in your condo, if you did not give insulin, you call it a PMBG (or AMBG).
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Noted! And that dictionary will come in handy, thanks!

Tricia Cinco(GA) & Harvey said:
So starting in the morning, you'd shoot .75 units at am and pm, and hold that dose for at least six cycles, unless Syko lets you know it's too much by dropping under 68 (assuming you are switching to TR?).
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I've had to mess with her dose a lot lately since the 'prescribed' dose was just not right. I'll probably try to stick with SLGS, not sure if I could commit to testing all day every day. We're still getting used to the ear pokes, she's started growling at me which she's never ever done, so I'm working on desensitizing her to them with treats and cuddles.
 
meowsyko said:
'll probably try to stick with SLGS, not sure if I could commit to testing all day every day.
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That is absolutely an option. Just know that you don't have to test "all day" to do TR. The protocol calls for at least three tests a day, although most of us recommend at least four - the pre-shots and one mid-cycle in am and one in pm. Many of us do more than that, but that is according to your schedule.

Are you giving a treat when you test, even if you don't get blood? That helps most kitties get used to it, and some even look forward to testing! :rolleyes:
 
Tricia Cinco(GA) & Harvey said:
Are you giving a treat when you test, even if you don't get blood? That helps most kitties get used to it, and some even look forward to testing! :rolleyes:
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I usually do. When it takes a few tries to get enough blood though, she gets mad at me. I accidentally poked myself the other day when she moved and I get it - it hurt! I know cats aren't supposed to have many nerves at the edge of their ears but she sure makes it seem like she does!

I think I'll head to bed now, she's happily snoring away. Thanks so much for all your help! :bighug:
 
Oh! I meant to ask - what carb % qualifies for middle and high carb food? should i get wet or dry to have around when i need it? (her regular food is 16% carb wet hill's d/d, i'm working on that one but can't afford lower-carb alternatives for her sensitive tummy atm).
 
Hi and welcome. Her regular food is middle carb and for some might qualify for hc if carb sensitive. So mc for your cat would be higher than what you are feeding. Do you know what she is sensitive to by any chance?
 
meowsyko said:
should i get wet or dry to have around when i need it?
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Wet is almost always better. As Elise indicated, what you should get depends on whether or not you know what she's sensitive to. Sometimes just adding a little honey to her regular food (and I mean a very little - drop or two) can make the difference, if you can't find another food she can safely eat.
 
@Chris & China
Chris & China said:
Below 90 (on either type of meter) is an automatic reduction of .25 unit on SLGS
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I don't really feel like making a whole new thread over this.. but I just got a 5.2 (93.6) at +2.5 tonight after trying out some new low carb food (Nature's Variety Instinct LID)! So I should be reducing again already to .5u? I just want to make sure! :cat:
 
meowsyko said:
So I should be reducing again already to .5u? I just want to make sure! :cat:
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No, she hasn't earned a reduction just yet, but with that big of a drop this early in the cycle, I'd make sure you get another test in at +3

If you haven't already done it, I'd go ahead and give her a teaspoon or two of her new LC food to hopefully slow down that drop

I don't know which method you're using, Tight Regulation or Start Low, Go Slow.....On TR you don't reduce until they drop below 68 on the AlphaTrak

On SLGS, you reduce when they drop below 90 on either a human or pet meter

I'm heading out for tonight, but if you need help, I'd start a new post and use the 911 if necessary to get some eyes on it. Don't forget to put the link to this post into a new one

I'll also tag @julie & punkin (ga) and @Wendy&Neko but I don't know how long they'll be on tonight
 
I'm headed for bed as well. Now that Sykos is in green numbers, it's a good idea to give him a couple of bites of his regular low carb food to help him surf. I'd dole that out every hour while he's in green.

Perhaps you and Teddy's mom can keep checking on each other - you're both new and up late with your kitties tonight.
 
Chris & China said:
No, she hasn't earned a reduction just yet, but with that big of a drop this early in the cycle, I'd make sure you get another test in at +3

If you haven't already done it, I'd go ahead and give her a teaspoon or two of her new LC food to hopefully slow down that drop

I don't know which method you're using, Tight Regulation or Start Low, Go Slow.....On TR you don't reduce until they drop below 68 on the AlphaTrak

On SLGS, you reduce when they drop below 90 on either a human or pet meter

I'm heading out for tonight, but if you need help, I'd start a new post and use the 911 if necessary to get some eyes on it. Don't forget to put the link to this post into a new one

I'll also tag @julie & punkin (ga) and @Wendy&Neko but I don't know how long they'll be on tonight
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Okay, thanks for the clarification! Just got a 91.8 at +3.5. She was sleeping, so not food-influenced yet. Doesn't seem to be dropping too fast but I'll stay up with her anyway. That link for 'dealing with low numbers' isn't working, but i'll look around for it!

julie & punkin (ga) said:
I'm headed for bed as well. Now that Sykos is in green numbers, it's a good idea to give him a couple of bites of his regular low carb food to help him surf. I'd dole that out every hour while he's in green.

Perhaps you and Teddy's mom can keep checking on each other - you're both new and up late with your kitties tonight.
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Okay I'll give her a bit of food though I'm not sure how much she'll eat. And I'll find Teddy's mom :) Thank you for your help!
 
meowsyko said:
Okay, thanks for the clarification! Just got a 91.8 at +3.5. She was sleeping, so not food-influenced yet. Doesn't seem to be dropping too fast but I'll stay up with her anyway. That link for 'dealing with low numbers' isn't working, but i'll look around for it!
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DON'T PANIC! or HOW TO HANDLE LOW NUMBERS
The following guidelines apply to those following the Tight Regulation Protocol only.
First, try to not panic.Post to the Lantus & Levemir Insulin Support Group or on the Health Board. Make sure your subject line indicates you are concerned about a possible hypo and/or add the 911 prefix to the first post in your thread. People who are experienced in dealing with low numbers will be there to help. After posting, remember to refresh your browser periodically to see if people have replied.

It’s important to recognize that just because your cat may be experiencing low BG numbers doesn’t mean that your kitty is critically hypoglycemic. Many cats will have low numbers and never have symptoms. It’s important, though, to bring those numbers up into a safe range. ALWAYS make sure you have a stock of test strips, high carb (HC) canned food that contains gravy and is over 15% carb such as Fancy Feast grilled, marinated, or Gravy Lovers varieties (see Dr. Lisa's Cat Food Nutritional Composition List for a full list of options), and/or a simple sugar solution such as Karo/corn syrup, honey, maple syrup, etc.
If your cat is experiencing symptoms, especially if those symptoms are severe, you need to rub Karo syrup, honey, or maple syrup on the gums or, if symptoms are very severe, administer rectally and get your cat to the nearest 24-hour emergency facility. Take the bottle of syrup with you to administer on the way if necessary. (Note that it is rare that we see episodes of symptomatic hypoglycemia with Lantus and even rarer to see severe symptoms. But, you need to know what to do should they occur.)

The symptoms to be concerned about include but are not limited to:
  • staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
  • ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
  • disorientation (yowling, walking in circles, etc.)
  • twitching
  • stupor
  • convulsions or seizures
  • coma

If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)
  • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
  • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
  • Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
  • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
  • Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.

In the case of an accidental overdose or should there be symptoms of hypoglycemia, even if you have caught this in the early stages, you may need to monitor for literally 16 or more hours. Lantus and Levemir are long acting types of insulin. This means if your cat is over dose, you will need to stay alert for hours in order to closely monitor and to keep your cat safe.

Please post your numbers. Those people who are helping you will not abandon you. In fact, they are staying up with you. The experienced people will even work in shifts to make sure your cat is safe and you have the support you need. Remember to refresh your browser to see new posts and keep posting so we know all is well.
 
Sorry, I'm running on about 4 hours sleep last night and Neko is giving a chance to catch up tonight. For some reason, I didn't get the tag.

Good luck, I hope Syko finds the 90's a good place to surf tonight.
 
we're back in the blue! +4 is 5.8/104. Haven't gotten much food in her at all either, so I guess I can probably stop worrying too much?
I'll still be up another hour probably so I'll do at least one more test before I head to bed.
 
meowsyko said:
so I guess I can probably stop worrying too much?
I'll still be up another hour probably so I'll do at least one more test before I head to bed.
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It looks like she's planning to just surf, which is wonderful - very healing for the pancreas. I would say another test in an hour, and provided she's not dropping, I would leave some LC food out and call it a night. I'll check back later to see how it's going.
 
Down to 86 at +5. I tested twice to make sure... Guess I'll go make some coffee and give her a bit more food! at what point to you feed higher carbs? I guess we're doing SLGS, so that earns her a dose reduction to .5u?
 
meowsyko said:
that earns her a dose reduction to .5u?
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Are you following SLGS or TR? If it's TR, then she has to drop below 68 on an AT meter. If following SLGS, it's 90 (although the instructions are written for a human meter, so a case could be made for reducing at 110 or below when using an Alpha Trak). HC is usually reserved for anything under the 68 on an AT, no matter which method you're following. You can give her some LC if you want, to slow her further. Or, if you REALLY need to go to bed (I know you have an early appointment), you can break out the HC. We call that "aborting the cycle".

I just tagged you on Teddy's condo with the link to our Slang Dictionary. It will help you understand some of the expressions and abbreviations we use here.
 
We're doing SLGS. So .5 tomorrow then. This was also with just one meal of low-carb food so I suspect this isn't our only late night this week!
I'll probably stay up with her a bit longer. The vet wanted a curve this week anyway, maybe i'll manage to get one tonight!:rolleyes:

I can always sleep after my appointment if she keeps me up :)

I'll definitely bookmark that dictionary. I can usually interpret most things, but some of the words are a bit odd :joyful:

Thanks so much for all your help! :bighug:
 
meowsyko said:
I can usually interpret most things, but some of the words are a bit odd :joyful:
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Quite a few of them originated as typos made by members back in the day, and they got picked up and just stuck around. If you happen to see something in a condo that you can't find in the dictionary, please let me know, as I'm trying to keep it up to date.
 
+6 was 103, but I accidentally gave her the higher-carb prescription food at +5 instead of low carb. Too many cans in my fridge at once!
So +6.5 is a liiittle more reliable, at 97. Hoping to get a +7 before I go to sleep. Syko isn't very happy about all the testing.
 
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